Claims Verification Specialist - No-Fault & WC

CitiMed; New York (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

CitiMed is seeking a Claims Verification Specialist to verify patient information, documents, and insurance for No-Fault, Workers’ Compensation, and lien cases. The role ensures accuracy in the system and supports timely reimbursements by maintaining clear communication with carriers and attorneys.

Responsibilities include updating EHR records, verifying eligibility, and coordinating with scheduling and billing to prevent delays and ensure compliance across multiple facilities.

Qualifications

• Understanding of NYS Workers Compensation/No Fault guidelines and processes.
• Extremely detailed oriented with strong problem-solving skills.
• Ability to think quickly and make accurate decisions in a fast-paced environment.
• Strong communication skills across diverse stakeholders.
• Knowledge of insurance and claims (No-Fault, WC, liens).
• Maintain accurate documentation for audits and compliance.

Responsibilities

• Verify patient demographics and all supporting documents before claim processing.
• Confirm eligibility, benefits, accident details, and coverage with carriers and attorneys.
• Communicate with patients’ attorneys to coordinate documentation and resolve issues.
• Ensure required documentation is obtained at scheduling or intake.
• Maintain up-to-date claim records in the EHR/system with contact details.
• Coordinate with scheduling to resolve missing information prior to visits.
• Notify billing staff of verification issues affecting 7-day DOS billing window.

Skills

NYS WC/NF guidelines

Attention to detail

Problem solving

Communication

Insurance knowledge

Documentation accuracy

Negotiation

Job description

CitiMed is seeking a Claims Verification Specialist to verify patient information, documents, and insurance for No-Fault, Workers’ Compensation, and lien cases. The role ensures accuracy in the system and supports timely reimbursements by maintaining clear communication with carriers and attorneys.

Responsibilities include updating EHR records, verifying eligibility, and coordinating with scheduling and billing to prevent delays and ensure compliance across multiple facilities.